Healthcare Provider Details

I. General information

NPI: 1992325401
Provider Name (Legal Business Name): JAMILA IQBAL RANAVAYA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2020
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 MEDICAL CENTER DR STE 3000
HUNTINGTON WV
25701-3656
US

IV. Provider business mailing address

1448 10TH AVE STE 304
HUNTINGTON WV
25701-3579
US

V. Phone/Fax

Practice location:
  • Phone: 304-691-1000
  • Fax: 304-691-1693
Mailing address:
  • Phone: 304-691-1000
  • Fax: 304-691-1693

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number32773
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: